Comparison of the predictive value of anthropometric indicators for the risk of benign prostatic hyperplasia in southern China / 亚洲男科学杂志(英文版)

This study aimed to compare the predictive value of six selected anthropometric indicators for benign prostatic hyperplasia (BPH). Males over 50 years of age who underwent health examinations at the Health Management Center of the Second Xiangya Hospital, Central South University (Changsha, China) from June to December 2020 were enrolled in this study. The characteristic data were collected, including basic anthropometric indices, lipid parameters, six anthropometric indicators, prostate-specific antigen, and total prostate volume. The odds ratios (ORs) with 95% confidence intervals (95% CIs) for all anthropometric parameters and BPH were calculated using binary logistic regression. To assess the diagnostic capability of each indicator for BPH and identify the appropriate cutoff values, receiver operating characteristic (ROC) curves and the related areas under the curves (AUCs) were utilized. All six indicators had diagnostic value for BPH (all P ≤ 0.001). The visceral adiposity index (VAI; AUC: 0.797, 95% CI: 0.759-0.834) had the highest AUC and therefore the highest diagnostic value. This was followed by the cardiometabolic index (CMI; AUC: 0.792, 95% CI: 0.753-0.831), lipid accumulation product (LAP; AUC: 0.766, 95% CI: 0.723-0.809), waist-to-hip ratio (WHR; AUC: 0.660, 95% CI: 0.609-0.712), waist-to-height ratio (WHtR; AUC: 0.639, 95% CI: 0.587-0.691), and body mass index (BMI; AUC: 0.592, 95% CI: 0.540-0.643). The sensitivity of CMI was the highest (92.1%), and WHtR had the highest specificity of 94.1%. CMI consistently showed the highest OR in the binary logistic regression analysis. BMI, WHtR, WHR, VAI, CMI, and LAP all influence the occurrence of BPH in middle-aged and older men (all P ≤ 0.001), and CMI is the best predictor of BPH.

Clinical features of testicular torsion and its misdiagnosis:analysis of 274 cases / 南方医科大学学报

OBJECTIVE@#To summarize the clinical characteristics of testicular torsion and explore the relationship between its incidence and temperature, the value of supplementary examinations, and the factors causing misdiagnosis and testicular lesions.@*METHODS@#We retrospectively analyzed the clinical data of the patients with testicular torsion diagnosed in 9 hospitals in Hunan Province from May 1, 2009 to November 1, 2018. The temperature at onset and WBC value after onset were analyzed. The misdiagnosis rate and testicular lesion rate in the first-visit hospitals were compared between the large general hospitals and local hospitals. The factors that affected the diagnosis and treatment of testicular torsion were analyzed.@*RESULTS@#A total of 274 cases were included in this study, and misdiagnoses occurred in 151 cases (61.9%). The initial diagnosis was made in large general hospitals in 59 cases; misdiagnosis occurred in 30.5% of the cases and the rate of testicular lesions was 57.6%. Of the 215 cases first diagnosed in local hospitals, only 82 cases were diagnosed correctly, and the misdiagnosis rate was as high as 61.9%; the rate of testicular lesion was 85.6% in these cases. There were significant differences in the misdiagnosis rate and testicular lesion rate between the two groups ( < 0.05).@*CONCLUSIONS@#The first-visit misdiagnosis rate of testicular torsion is much lower and the probability of testicle preservation is significantly higher in large general hospitals than in the local hospitals, suggesting the importance of health education for testicular torsion, enhancing the awareness of this condition and training of the surgeons in primary hospitals.

Exploration of hematuria in urinary system integrated courses for eight-year medical educa-tion program / 中华医学教育探索杂志

Organ system based integrated teaching model has been adopted in several medical schools, and these schools face some challenges in this teaching process. In order to provide new sights for organ system based integrated teaching reform in eight-year medical education program, ex-ploration of setting up three-staged-dimensional integrated teaching models was conducted in urinary system by hematuria, and designing related teaching objectives, teaching programs and assessment form to optimize teaching quality in this teaching methods, according to characteristics of the urinary systemic diseases, cultivating objectives of eight-year medical education program and teaching experi-ence of Xiangya School of Medicine.

Minimal Hydrocelectomy with the aid of scrotoscope: a ten-year experience

Background Since hydrocelectomy remains the choice of surgical treatment of hydrocele and standard surgical procedures may cause postoperative discomfort and complications, a new minimal surgery procedure is needed. The scrotoscope was used for the diagnosis and treatment of intrascrotal lesions. The aim of the study is to illustrate a new minimal hydrocelectomy with the aid of scrotoscope, in an effort to decrease complications. Materials and Methods: Between 2002 and 2012, 65 patients underwent hydrocelectomy with the aid of a scrotoscope. Before carrying out hydrocelectomy, the scrotoscopy was first used to examine the intrascrotal contents to exclude any pathological lesions. After determining the condition of testis, epididymis and spermatic cord and excluding any other secondary causes of hydrocele, a 2.0cm scrotal incision was performed. The parietal tunica vaginalis was then grasped out of scrotum, and the mobilized tunica was excised. The scrotoscopy was then performed again to inspect the intrascrotal contents. Results Mean operative time was 35.4 minutes. No major complications occurred during the post-operative follow-up period. Of these 65 patients, 61 underwent scrotoscopy and minimal hydrocelectomy, two patients underwent open hydrocelectomy because thickening of hydrocele wall was identified; two patients with acute inflammation only underwent scrotoscopy. Pathological changes were observed among eight patients. All patients were satisfied with the outcomes. Conclusions Minimal hydrocelectomy shows commendable results and fewer complications. The combination of minimal hydrocelectomy and scrotoscopy seems to be an encouraging technique. This novel surgical procedure proves to be a viable option for the diagnosis and treatment of hydrocele. .

Bladder interstitial cells and pathophysiology / 中南大学学报(医学版)

Bladder interstitial cell (IC) is a cell, which lacks thick filaments and dense bodies but with incomplete basement membrane, rough endoplasmic reticulum and golgi apparatus. IC is divided into 4 subtypes: lamina propria IC, intramuscular IC, IC between the detrusor bundles and perivascular IC. There are different ion currents and related activation pathways in the lamina propria IC and intramuscular IC. Ca2+ signaling pathways play an important role in the communication between IC and detrusor. Any bladder lesions affecting the ion current and Ca2+ signaling pathways can lead to bladder dysfunction. The bladder lesions include bladder outlet obstruction, bladder pain syndrome, interstitial cystitis, neurogenic bladder and diabetes. Imatinib mesylate is currently an available treatment target in IC, and electrical stimulation of acupuncture therapy is a new direction.

Factors influencing the diagnosis and treatment of chronic prostatitis among urologists in China / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To identify the factors influencing diagnosis and treatment of chronic prostatitis (CP) among Chinese urologists.</p><p><b>METHODS</b>A sample of 656 urologists from 29 provinces of China were asked to complete a questionnaire that explored attitudes towards CP as well as diagnosis and treatment patterns in the management of CP. Both univariate and multivariate logistic regression analysis schemes were used to determine the factors that influence the diagnosis and treatment of CP.</p><p><b>RESULTS</b>A total of 656 questionnaires were given out. All were returned and 410 of those were included in the final univariate and multivariate analysis. Multivariate logistic regression analysis indicated that belief of bacterial infection in the etiology of CP (odds ratio [OR], 2.544; 95% confidence interval [CI], 1.650-3.923; P < 0.001) was the most significant factor influencing the routine performance of bacterial culture test. Using the same model, the type of hospital (OR, 2.799; 95% CI, 1.719-4.559; P < 0.001) and the routine use of the 4- or the 2-glass test (OR, 3.194; 95% CI, 2.069-4.931; P < 0.001) were determined to be significant factors influencing the use of the National Institutes of Health (NIH) new classification system. According to the same model, belief of bacterial infection in the etiology of CP (OR, 3.415; 95% CI, 2.024-5.762; P < 0.001) and the routine use of bacterial culture test (OR, 2.261; 95% CI, 1.364-3.749; P < 0.01) were important factors influencing the routine prescription of antibiotics.</p><p><b>CONCLUSION</b>Our findings suggest that attitudes towards CP, and the characteristics of individual urologists' practices may influence the diagnosis and treatment of CP among Chinese urologists.</p>

Protective effects of estrogen on mitochondria in human umbilical vascular endothelial cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the protective effects of estrogen on the mitochondria in human umbilical vascular endothelial cells (HUVECs).</p><p><b>METHODS</b>HUVECs were exposed to H2O2 at 250 micromol/L for 4 h with or without pretreatment with 17-estradiol (E2) and ICI182780. Complex IV activity of the cells was measured with chromometry, and 2, 7-dichlorofluorescein diacetate (DCFH-DA) was used to determine intracellular reactive oxygen species (ROS). Intracellular adenosine triphosphate (ATP) level was quantified with a luciferin- and luciferase-based assay.</p><p><b>RESULTS</b>Compared to the blank control group, H2O2 caused a decrease in complex IV activity, intracellular ATP level, and the cell viability, but elevated intracellular ROS. E2 pretreatment of cells significantly attenuated these effects of H2O2 exposure. ICI182780 administered prior to E2 pretreatment antagonized the protective effects of E2 against H2O2 exposure.</p><p><b>CONCLUSION</b>E2 offers mitochondrial protective effects on HUVECs, which is mediated by the estrogen receptors.</p>

A new synthetic tripeptide inhibits L-arginine transport in macrophages / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the effect of a new synthetic tripeptide [Arg(NO(3))- Lys(OCH(3))- Arg(NO(3))] on L-arginine/NO pathway in the macrophage cell strain RAW246.7.</p><p><b>METHODS</b>The cultured macrophages exposed to lipopolysaccharide (LPS, 1 microg/L) treatment were randomly divided into 3 groups (n=6) and treated with distilled water, 1x10(-4) mol/L tripeptide and 1x10(-4) mol/L L-arginine, NG-monomethyl-L-arginine (L-NMMA) for 24 h, respectively. The macrophages were incubated for 24 h with LPS (1 microg/L) and in the presence of different concentrations of L-arginine (0 to 2 mmol/L), or in normal culture medium (containing 0.5 mmol/L L-arginine) for 24 h with LPS (1 microg/L) and in the presence of tripeptide of 0 to 10x10(-4) mol/L. The changes of [(3)H]-L-arginine transport and NO production from the macrophages were measured.</p><p><b>RESULT</b>NO release from macrophages incubated in the LPS-containing culture medium was 50 folds, and [(3)H]-L-arginine uptake 2.7 folds that in cells in normal culture medium. Tripeptide (1x10(-4) mol/L) inhibited [(3)H]-L-arginine transport and NO production by 67% and 71% respectively. The effect of tripeptide was stronger than L-NMMA (P<0.05). Extracellular L-arginine caused a concentration-dependent increase in nitrite production, which reached the maximum at concentrations above 0.5 mmol/L Km for nitrite production of 0.162+/-0.015 mmol/L and Vmax of 91.2+/-2.3 micromol/(24h.10(6) cells). L-arginine transport and NO production were inhibited by tripeptide, but their dose-dependent pattern of changes was different with EC50 of 0.21x10(-4) mol/L and 1.27x10(-4) mol/L, respectively.</p><p><b>CONCLUSIONS</b>Activation of macrophages with LPS induces nitrite accumulation in the culture medium, which is dependent on the presence of extracellular L-arginine. The tripeptide induces dysfunction of L-arginine/NO pathway in macrophages, potently inhibits L-arginine transport and competitively combine the active sites of nitric oxide synthase.</p>